When nurses began mobilizing around wife abuse in the late 1970s, they faced a dismal situation. Indeed, the interactions between battered women and their doctors during the 1970s reveal a widespread pattern of medical dismissal of patient complaints and the overall noninvolvement of doctors into the causes and remedies for battering.

Battered Wives was the first book on domestic violence published in the United States, Del Martin, 1976Courtesy National Library of Medicine

In a letter written in the early 1970s, one battered woman described the medical neglect she encountered after a series of excessive beatings by her husband; these beatings included being whipped, thrown on the floor, kicked in the abdomen while pregnant, and hit in the head, chest, and face. After finding no support from local clergy (the clergyman told her to “be more tolerant and understanding” [and] forgive him the beatings just as Christ had forgiven me from the cross”), she turned to her doctor for help. She reported, “I was given little pills to relax me and told to take things a little easier. I was just too nervous… I did go to two more doctors. One asked me what I had done to provoke my husband. The other asked if we had made up yet.” This story was reported in feminist activist Del Martin’s groundbreaking exposé of domestic violence in 1976, Battered Wives. This survivor’s story is consistent with accounts from thousands of other abused women at the time.

Medicine typically constructed the battering as a “private” event, one that the provider sought to keep at a distance. As one doctor explained to researchers, “If a woman comes in with bruises—how did you get those bruises, what happened—I fell down the stairs, we accept her reasons for the injuries. Upon further examination, however, I may feel that she didn’t sustain these bruises by falling down the stairs. Somebody may have hit her. But I do not ask her or delve any further with it. Accept the patient’s theory… We don’t have the time or the inclination to go into sociological background as for the reason of the assault…. It’s a personal problem between a man and wife” (italics mine). Additionally, the dominant medical opinion saw battering as the result of the woman’s own psychopathology, be it her alcoholism, depression, emotional instability, or other “psychiatric problem of the victim.” These presenting problems were also taken as isolated and separate from the context of the ongoing abuse she was subjected to.

Those doctors who believed that women themselves were the root of the problem, had no empathy for their abuse. An EMT in southern Missouri confirmed that, “the attitude of local doctors and ED [staff] are that battered wives deserve what they get.” Others chose not to believe their patients at all. Researchers in the late 1970s found that victims of spousal abuse “consistently report that physicians refuse to accept their claims of brutalization.” With this dominant understanding, little to no medical attention was paid to the overall plight of battered wives. Researchers reported in 1977 that there were no studies of battered wives, that little was known about them, and thus there was no protocol for how to reduce harm to them.

Brochure from Shelter Our Sisters, one of the first domestic violence shelters in the nation in Bergen County, NJ, ca. 1979 Courtesy of the National Library of Medicine

Brochure from Shelter Our Sisters, one of the first domestic violence shelters in the nation in Bergen County, NJ, ca. 1979 Courtesy of the National Library of Medicine

Medical treatment of battered women was limited to the issue needing immediate attention, be it a broken arm, laceration, or other injury. An emergency department surgeon perfectly encapsulated the mindset of medicine vis à vis battering when he said, “It is none of my business who hit her. I am just here to treat her.” How the injury happened was irrelevant to the physician. As one group of researchers commented, “the fact that the injury was caused by a ‘punch’ is no more significant than that it resulted from a ‘fall.’ ” In one example, a battered woman suffered paralysis of one side of her body for five days after a severe head injury caused by a male batterer. When she sought medical treatment, medical staff paid no attention to the cause of her affliction during either the initial appointment or her follow-up, and focused solely on the presenting, physical medical issue. Similarly, sociologists Dobash and Dobash found that of those few who did seek medical attention, 75% received treatment only for their physical injuries, despite the fact that many had told the doctor the cause of their injuries.

In this climate, nurses would begin to advocate for change.

Working on Wife Abuse, a directory of services for survivors of domestic violence, compiled by Betsy Warrior, 1978Courtesy National Library of Medicine